KIDS + YOUTH CHURCH REGISTRATION FORM • St Marks Anglican Freshwater

PLEASE NOTE:

Your child's wellbeing is paramount to us. All Kids + Youth Leaders at St Marks hold a current Working With Children Check and have completed Safe Ministry Training.

By submitting this form you are agreeing to the following:

I consent to my child attending St Marks Anglican Freshwater Kids or Youth Church.
I release and discharge all associated with St Marks Anglican Church, Freshwater, from all responsibility and liability for any accident or sickness which may befall the child specified below, or any damage to his or her property while attending Kids or Youth Church.

PARENT / GUARDIAN DETAILS

Parent/guardian name *

Mobile Number *

Email Address *

Are there any other adults who may collect your child from their program? (eg. another parent, grandparent, or guardian) *

YES

Please provide the MOBILE NUMBER for any additional adults permitted to collect your child from their program *

CHILD DETAILS

First Name *

Last Name *

Date of Birth *

Gender *

Current School Year *

Please select which program your child/youth will be attending... *

Little Sparks (ages 1-2)

Preschool Church (ages 3-5)

Kids' Church (years K-4)

Youth Church (years 5-8)

IMPORTANT INFORMATION

Does your child have ALLERGIES / SPECIAL NEEDS / DIAGNOSES you would like to inform us about? *

YES

If Yes, please provide more information so we can appropriately care for your child. *

Tip: please also VERBALLY communicate these needs to your child's Program Leader.

Please describe your child's stage of toilet training *

My child is toilet trained

My child is in the process of being toilet trained

My child is not yet toilet trained

Does your child require bathroom assistance? *

My child can go to the bathroom independently

My child needs bathroom reminders

My child is not yet toilet trained

Tip: please also VERBALLY communicate any bathroom assistance requirements to your child's Program Leader.

Is there anything else you'd like to let us know to assist us in caring for your child?

Is there anyone who is not permitted to interact with your child? Please ensure you list their full name.

MEDIA PERMISSION?

I am willing for my child to be filmed or photographed at events and programs run by St Marks Freshwater and for these photos/videos to be used to promote the ministry of St Marks in a way that does not identify their name or personal details. *

YES

PARENT / GUARDIAN CONSENT

I agree to keep my phone with me in case I need to be contacted during the service in relation to my child's wellbeing. *

YES

If my child is feeling distressed, I understand that I may need to collect my child prior to the conclusion of the service. *

YES

I agree to collect my child from their program in a timely manner at the conclusion of the service. *

YES

SAFETY & PRIVACY POLICY

St Marks is committed to the physical, emotional, and spiritual wellbeing of everyone within our community, as well as the appropriate treatment of data and confidential information. Please note: the information in this form may be shared with a third party when it concerns medical health or care of the individuals listed.

Please click here for more information about our safety procedures and privacy policy.

If you have any questions, please do not hesitate to contact us.